We should just let the elderly have legal and free access to every drug imaginable and let them just go hog wild. It'll encourage healthy habits and eating. You have lived passed 95? You just earned yourself a free state subsidized cocaine fueled bender, grandma!posted by TwelveTwo at 6:05 PM on April 30, 2011 [37 favorites]

“To die with this helium just takes you a couple of minutes and [you] die peacefully,” said Sharlotte,

I couldn't get very far down in the comments before I wanted to smack people. Not for their opinions, but for so completely and stupidly missing the point. I suppose that's partly because of a lack of empathy, which prevents understanding. But not even trying...that's just inexcusable.

That's one reason I love MetaFilter. Calling us out on our bullshit.posted by Xoebe at 6:10 PM on April 30, 2011 [1 favorite]

The Medical community needs to do everything it can to stay out of the business of murder.

Proper compassion and pain control provided by hospice can eliminate incidents such this woman's husband allegedly experienced and provide the dignity sought for.posted by pianomover at 6:11 PM on April 30, 2011 [3 favorites]

said Sharlotte, who only wants to be identified by her first name.

They'll never track her down. There must be a million 91-year-olds named Sharlotte in California.posted by Horace Rumpole at 6:12 PM on April 30, 2011 [5 favorites]

Oh, yeah, and on helium - you can do it with just about any gas except carbon dioxide.

You don't see this argument pointed out very often, but the gas chamber would be very humane if it were just a nitrogen filled room. There is no reason for poison. And that implies that lethal injection, or poison gas, are administered for reasons other than humane execution.posted by Xoebe at 6:14 PM on April 30, 2011 [43 favorites]

The controversy regarding medically assisted suicide and the arguments on both sides of the issue are significant. There are so many issues to consider, proper assessment of mental state the individual considering the procedure is likely paramount but the merits of a society that does not hold the sanctity of life in a reasonable regard is also something to deeply consider.

Whatever the merits are to the issues involved one thing we can all be sure of: someone who advertises their suicide assistance services anonymously in the internet not likely to not have the bests interests of anyone involved in mind - at the very least.

The actual post points to one of her clients , a 29 year old young man who was tired of hos depression that she helped kill. Could a better example of worse judgement be found? Seven years ago, during the worst and most extendedly depressing time in my life I attempted suicide. I was resigned to the act and was glad to be getting it over with. It was nothing less than a relief from what I felt then to be unimaginable pain. Due to a bizarrely unexplainable set of circumstances the attempt failed, though by all rights it should not. Seven years later I am glad that I am alive and have had these years with hopefully many more to come. I cannot adequately express the animosity that I have for people like this older woman who would have apparently gladly assisted me in my action back then.

She is neither qualified nor competent to be providing this "assistance"by herself. I do hope that she is discovered and prosecuted appropriately. Assisted suicide should be something assisted by a larger more professionally informed group of people - not by this one person.posted by Poet_Lariat at 6:30 PM on April 30, 2011 [26 favorites]

Huh, I was actually reading an article about someone here in Oregon taking their life with a "helium hood" suicide kid he bought off the Internet. Wouldn't have guessed it was a 91-year-old lady behind these.

"Opponents to changing the law point to one of Sharlotte’s clients... a 29-year-old Oregon native. He wasn’t suffering from a terminal illness. He opted out because he was tired of dealing with his chronic depression. His suicide touched off a major controversy."

Severe depression is no less debilitating or painful a condition as cancer, and those who suffer from it are no less deserving of a way to escape it.posted by dephlogisticated at 6:50 PM on April 30, 2011 [38 favorites]

The Grim Reaper tells the 91 year old Sharlotte, "I appreciate the help, but I got this. But.... while I am here, I need to tell you something."posted by Senator at 6:51 PM on April 30, 2011 [4 favorites]

Does the guy at the end of the video realize that he can easily go down to the local high school and buy a firearm or two? And he wants to band grandma's suicide baggie? hrm.posted by weezy at 6:51 PM on April 30, 2011 [1 favorite]

Can helium get you high? I imagine it depends on how much you inhale and how long you hold it.posted by hal9k at 6:57 PM on April 30, 2011 [1 favorite]

"Severe depression is no less debilitating or painful a condition as cancer, and those who suffer from it are no less deserving of a way to escape it."

This is true but, unlike many cancers, there happens to be alternate ways to do it. We should advocate for those.posted by Blasdelb at 6:59 PM on April 30, 2011 [1 favorite]

I hate to say it, but I suspect that there will come a point when we living folks will welcome these kits for others, because that means more for us.posted by Melismata at 7:02 PM on April 30, 2011

One of the things that I address DAILY as I work in disability rights/advocacy is that there are two basic types of people who feel the need to have opinions on issues about other people and their bodies.

We (my coworkers, friends, other activists) believe that we each have a right to live our own lives and make our own decisions and to not, unless we want to, die cooped up in a nursing home because the nursing home lobby is a super-rich, insidious bastard of a motherfucker who eats more money than most people know about. We believe that we each have ownership of our own lives and our own decisions, good or bad.

Almost all of the people who oppose what we do (seriously, there are people who oppose the concept of letting people live at home instead of in state funded nursing homes) and some of the bills we fight for believe that the poor, the sick, the weak, the minority, the whomever---are (as close as I can compare) resources to be managed, cattle to be directed.

I found this when I worked for Habitat (which is why I left Habitat), that there are sooooo many people who do something "because these people are poor" or "because they're sick" or some other bunch of flaming BS and not "because they're a person." I don't care if you're white or purple or sick or healthy, if you're a right fuckwad I don't mind telling you---but even if you are I support your right to make decisions for your OWN life. Period.

There is no reason to prosecute this woman just like there's no reason to judge the people who make use of these (or any) products to aid the taking of their own lives. Judging it DEFEATS THE PURPOSE.

Life is beautiful, pain and suffering are inhumane and intolerable and unnecessary. Should I get sick beyond healing, I certainly intend to give death the old middle finger as I make one last decision about something I can actually control, rather than die in a narcotics-induced semi-coma in an assisted living facility as some folks up-thread seem to think people should be forced to die.posted by TomMelee at 7:06 PM on April 30, 2011 [61 favorites]

After 20 years of depression and almost every med known in every combo plus countless years of therapy I'm grateful for a woman like this and her wares for at least making a topic of consideration. My suicide attempts failed and I know I could do try again at a moment's notice but fear of injury and the belief that in a just world the medical establishment should be able to help me die with dignity keep me going. When I can find a doctor who will help me gracefully end the depression I will. When we advocate for assisted suicide it should be for all. Not just the elderly.posted by kanata at 7:06 PM on April 30, 2011 [10 favorites]

Blasdelb, I agree. Treatment should always be the first option, and suicide the last. Most suicides are done impulsively, and most survivors end up regretting the act.

Nonetheless, there are many people who suffer from chronic and severe depression who are unable to find effective treatment. In these cases, there comes a point where allowing them to die is more humane than forcing them to live.posted by dephlogisticated at 7:08 PM on April 30, 2011 [5 favorites]

Unconsciousness takes a minute or two, but death takes at least another five minutes, and you'd be safer with 10 minutes total gas running time.

As you get toward the end, long after the relatively immediate unconsciousness, there is open-mouthed gasping and full-body spasms. It's very disturbing for the survivors.

Anything's cheaper than helium. As noted above, it has to be free of carbon dioxide.posted by the Real Dan at 7:08 PM on April 30, 2011

I don't get why you even bother selling/buying a kit. You still need to aquire the helium, and a tube and plastic to put over your head are going to be just as easy to get. This could just be some instructions. I have a hard time imagining the tortured soul that is motivated enough to take their own life, but before the introduction of this product it just was too inconvenient. Who has the time?posted by floam at 7:10 PM on April 30, 2011

there comes a point where allowing them to die is more humane than forcing them to live.

We are compassion pirates offering you a choice. Step off the plank on your own into the shark infested waters or we'll push you off.posted by pianomover at 7:22 PM on April 30, 2011

My grandmother lived to 103. I broached this issue with her she was 99. She said it pays to have a good doctor and have a little pill. She did not have the that pill and spent her last year in 1909. She loved candy. (she saw teddy give a speech) ohhhh, as she would say, none the less...
"People should be given the right to choose" She was a good republican. She was an advocate of every right to choose, every right except hard drugs being legal and Henry Miller novels. I sold here on hard drug usage for terminally Ill people. I go on because i could not do this if I had power of attorney. 1909 looked fun. But to the suffering, this is another matter. A matter of a hard choice.posted by clavdivs at 7:26 PM on April 30, 2011 [1 favorite]

dephlogisticated: Severe depression is no less debilitating or painful a condition as cancer, and those who suffer from it are no less deserving of a way to escape it.

Quoted for truth, and of course, it should not be the first option. I think part of the problem is that there's often a lot of lip service paid to the idea of biopsychosocial treatment of mental illness -- that is, treating all aspects of a disease, rather than just the biology -- when in reality patients are sometimes offered pharmacologic treatment and not much more. For those who respond to medication or ECT, fantastic, but for those who don't, it can often be a tough go trying to find other sorts of treatment.

Here in Ontario, for example, our provincial health insurance doesn't cover psychotherapy provided by a non-physician, and it can awfully difficult to find doctors who offer psychotherapy. (There's a recent move towards encouraging general practitioners to become GP-psychotherapists, but I don't know if the supply will meet the demand.) Even then, if one does find a therapist that's covered, there's no guarantee that (a) patient and doctor will be a good match, (b) the right sort of psychotherapy will be used, or (c) that it'll be succesful.

Another issue is, I think, the polarization between palliative care providers and those who support assisted suicide. The palliative folks (who, for the most part, do wonderful work) assume that everyone who is suicidal can be made to feel not suicidal if they know that they'll be treated with comfort and dignity and that they won't face pain in their dying days. It might be true for many, but there are always going to be people who would prefer to just end their lives rather than prolonging their existence. Why shouldn't there be room for both approaches?posted by greatgefilte at 7:28 PM on April 30, 2011 [8 favorites]

I have a hard time imagining the tortured soul that is motivated enough to take their own life, but before the introduction of this product it just was too inconvenient.

I have an easy time imagining that-- not surprising that somebody suffering depression was the only purchaser mentioned in the article.

Proper compassion and pain control provided by hospice can eliminate incidents such this woman's husband allegedly experienced and provide the dignity sought for.

I don't think that's true. Pain control is not that perfect. It comes with its own indignities, and sometimes, the dose that would control the pain is the dose that would stop your breathing.posted by nathan v at 7:30 PM on April 30, 2011 [2 favorites]

WTF? Do you even hear yourself?

In the United States, expressing both ideation and intent to commit suicide is considered justification for forced hospitalization and treatment. It is also a felony to assist someone to commit suicide, though two states allow doctors to assist under specific circumstances.

In other words, the law currently does not allow suicide, and if you express a desire to die, it can literally force you to live.

Mom killed herself when she was 70. Did it with a .357 to the right temple. She'd been suffering from bipolar disorder (and I mean seriously) for years. In and out of nursing homes and facilities she hated. I cannot find it in my heart to judge her for what she did, and I might well have done it were I in her shoes. I only wish she'd had a more peaceful means to do it; the inherent violence of the gunshot wound was just an extra layer of trauma to the whole family, and not the way she deserved to end her days.

My Grandfather died when he was 89. Bladder cancer. I spoke to him a few months before he passed. He said the pain was not the worst part of it. The worst part, he said, was losing both bladder and anal control and knowing he was only getting worse. He had always been a dignified man and the indignity of his incontinence was excruciating.

My stepdad is 84 and suffering from many ailments, including a disability from his diabetes amputation. He lives with me and laments on a regular basis the fact that he's still alive. He's overjoyed that his final years, though, are not being spent in a nursing home, for myriad reasons.

I suspect when I'm his age, I'll find a way to slip peacefully away, if my friends/relatives don't thwart my plans. I don't urge anyone to take that path as a first option. But should I get there, I think I'll have earned the right to make that decision for myself.posted by darkstar at 7:40 PM on April 30, 2011 [19 favorites]

nathan v: sometimes, the dose that would control the pain is the dose that would stop your breathing.

The Law? Really? That's your big contribution to the thread? Do you want to play let's quote an idiotic law game?posted by c13 at 7:43 PM on April 30, 2011

This woman is selling, likely at a profit, devices that enable people to kill themselves, with zero oversight. How would we feel about it if instead of a grandmother selling these plastic masks for $60, it was a 40 year old guy with a handgun offering to shoot suicidal people in the head for $60 a pop?

There are really difficult and legitimate questions about over there should be a right to die. I think there ought to be. But you have to have safeguards to show people are giving informed consent, that they're not making rash decisions or being coerced, and it has to come with some independent oversight. It's beyond the pale to have this woman selling this stuff to whoever she decides she wants to.posted by dixiecupdrinking at 7:46 PM on April 30, 2011 [11 favorites]

c13, his response seems perfectly reasonable. Why don't you explain what your objection to his wording is, rather than leaving him (and us) to intuit and infer what you mean?posted by darkstar at 7:47 PM on April 30, 2011 [8 favorites]

I just saw You Don't Know Jack for the first time yesterday and was thoroughly impressed. I remember hearing a lot about Jack Kevorkian in the 90's, but mostly along the lines of "hey there's this guy, and he's DR. DEATH because he helps kill people." I didn't really understand the legal context of what was going, and I think the movie helped in this regard. Kevorkian's 60 minutes interview is essential viewing.

For many years, the only thing that kept me from buying a gun or stepping in front of an 18-wheeler was the crippling, paralyzing fear that I'd screw it up somehow and survive, a vegetable. Especially since my previous suicide attempts, from when I was younger, failed.

I don't get why you even bother selling/buying a kit. You still need to aquire the helium, and a tube and plastic to put over your head are going to be just as easy to get. This could just be some instructions. I have a hard time imagining the tortured soul that is motivated enough to take their own life, but before the introduction of this product it just was too inconvenient.

The human body is difficult to kill. You'd be surprised how likely it is that a person throws themselves from a high elevation or shoots themselves in the head and remains alive, though these things are considered 100% effective suicide methods.

Even worse, some people are confused about the actual effects of suicide methods -- did you know that large quantities of tylenol can just utterly destroy the liver, and lead to a situation in which a person goes into a coma and dies after several days of knowing that they're gone? Or that swallowing drain cleaner probably won't kill you, but it will leave you in agony and crippled for the rest of your life?

In fact, asphyxiation on non-CO2 gases is by far the easiest way to kill oneself, but that is not common knowledge, and it leads to agonizing cases of near-suicide all the time. You're right: there are plenty of people motivated to take their life, but before the introduction of this they weren't able to do it painlessly and effectively. This product spreads knowledge and acceptance, and it's a lot better than just taking a random guess at something that might do you in.posted by TypographicalError at 7:55 PM on April 30, 2011 [7 favorites]

Well, for one it sounded incredibly arrogant. I'm not sure about the reason to bring up laws into the dicussion. Obviously the reason we're in a such absurd situation, where suffering people are reduced to buying damn suiside kits from Gradma Kevorkian is because of the legal system. What's the use of bringing that up? I mean, anal sex is also illigal in a whole bunch of places...posted by c13 at 7:57 PM on April 30, 2011

But you have to have safeguards to show people are giving informed consent, that they're not making rash decisions or being coerced, and it has to come with some independent oversight.

I agree. The problem is that, by making blanket laws forbidding suicide, the state has relinquished all power to regulate it. I'd prefer some oversight over none, but I'd also prefer an unregulated option over no option at all.posted by dephlogisticated at 7:57 PM on April 30, 2011 [2 favorites]

I believe that there is no right more important than a person's right to self-determination.

And if that self-determination means self extermination, so be it.

However, I also think there are safeguards that can be put into place to prevent impulse suicides. A cooling-off period in a facility (say, 72 hours) during which the subject receives an assessment establishing that a) they are of sound mind (depression would not be a criterion for disallowal, but a seriously disordered mental state would), and b) are under no compulsion from an external party.

After that, the Nitrogen Room is this way, if you please. Care to select a film or music? (I know this sounds Soylent Green-ish, but I don't find it objectionable).posted by chimaera at 8:15 PM on April 30, 2011 [4 favorites]

I agree. The problem is that, by making blanket laws forbidding suicide, the state has relinquished all power to regulate it. I'd prefer some oversight over none, but I'd also prefer an unregulated option over no option at all.

Yeah, I guess we fall on different sides of that line. I find it hard to accept this as legitimate, when we can't know whether any of her customers turn out to be, say, bullied 15 year olds, or victims of domestic violence, or lots of other groups of people who deserve to have other options.

I also think this is one of those issues that will gain a consensus as the years go on. Washington and Oregon have laws allowing physician-assisted suicide. The Supreme Court has suggested there may be a constitutional right to palliative care. I think that years down the road we'll recognize people's right to self-determination extends this far. But I think that stories like Sharlotte's play right into the fears of those who oppose this kind of thing, and it's frustrating to see.

Of course, a broader political trend doesn't help those who are suffering and want to die now, so I respect that even if I'm right people might not find it a compelling stance.posted by dixiecupdrinking at 8:20 PM on April 30, 2011 [1 favorite]

I think that a person is not a property of the state. Therefore the decision regarding suicide should be left up to the individual. As far as questions of competency, we already have well established tests for that. All other medical decisions are subject to them.
Furthermore, I think that physicians need to be taught when to stop and let people be. We're taught to do an try. And we end up, as they say, smart but without a lick of sense.posted by c13 at 8:24 PM on April 30, 2011

c13: "Furthermore, I think that physicians need to be taught when to stop and let people be. We're taught to do an try. And we end up, as they say, smart but without a lick of sense."

How on earth does this differ from the statement "allowing them to die is more humane than forcing them to live" that you so loudly disagreed with?posted by Hargrimm at 8:27 PM on April 30, 2011 [5 favorites]

c13, I think we're pretty much in agreement.

After that, the Nitrogen Room is this way, if you please.

State-facilitated suicide is a (rightfully) icky subject, but since you bring it up, here's something worth considering: approximately 34,000 people die of suicide in the US every year, while approximately 7,000 die waiting for transplant organs. There is currently no means by which someone who wants to die can give their organs to someone who wants to live.posted by dephlogisticated at 8:31 PM on April 30, 2011 [8 favorites]

"Allowing" and " forcing" presuppose taking the right to decide away from the individual.
Is that not obvious?posted by c13 at 8:40 PM on April 30, 2011 [1 favorite]

I think that there is a real market for an easy suicide kit. This isn't just for people that are so depressed that they can barely get up in the morning; it's also for people who are, because of debility, dependent on others (for just about everything) that would never let those people take their own lives.

I've separated these groups, but they're not so easily separated. I don't think there's some magical line where somebody on side counts as being depressed and somebody on the other side doesn't. And people with chronic pain, suffering terminal illness or debility, maybe facing death in the near future, are especially vulnerable to depression.

I really don't know what to do about suicidally depressed folks. I've physically restrained suicidal people-- been swung at by them, tied them up, doped them up. I don't even know how I feel about that. I don't know if I did right, or if it's a situation so hazardous that I never ever want to be there again.

I do know how I feel about people clearly in the second category. I strongly believe in respecting their ability to make the decision to end their life, and to follow through with that decision. I don't want anyone to ever have to be in a position to have to assist with a loved one's suicide, but I don't think it's right to deny them suicide because of that.

I don't know how to feel about these kits. Good? Bad? I'm not even sure that it'd be possible for me to know how to feel!

But I do think that we (yup, us regular people) can each do something to get rid of the demand for these kits:

We can care about people, both about their pain, and about their autonomy. We can advocate for people's autonomy to each other, and that way, there will be fewer caregivers willing to block a person's heartfelt decision to die. We can make efforts to hear each other's pain (sometimes you have to listen very carefully, because it can be very quiet!) and do whatever we can to relieve each others' pains, be they the pains of a 29-year-old or the pains of a 90-year-old.

It's not perfect, and it's something we all knew anyways, but I know that, at least for me, it helps to be reminded. Sorry for the sappiness!posted by nathan v at 8:48 PM on April 30, 2011 [2 favorites]

"Allowing" and " forcing" presuppose taking the right to decide away from the individual.

c13, what is it that you think laws do? They take rights away from individuals.

For example, a law prohibiting assault and battery takes away your right to swing your fist into my head.

In this case, certain laws in certain jurisdictions deny people the right to attempt to end their own lives, or assist some in ending their own life. All dephlogisticated did was state that, in those terms. That is not arrogant, it is factual.

I didn't realize it was *so* easy. I'm glad to know. I've got a trove of pills here but I've known people who've lived through that and not woken up real happy. I've got guns, too, but I'd want to give them to my friends or my nephew maybe, no need for a pistol to end up in the cop-shop just because I'd used it to leave the scene. And it is truly a nasty thing to leave behind, a big mess, plus even that can go wrong -- a kid I mentor, his brother did it, unbelievable depression, and didn't take himself out, used a shotgun but it didn't work out, there were bloody hand-prints all over the apt -- yikes. He shared that apt with his brother, my friend; I know for a fact he'd rather have come home to a can of helium and a baggie. It shook him, hard.

Why do I have a trove of pills, why am I interested in this? Alzheimers has taken all of my fathers siblings, and his mother, and it took so much of him before it finally took him out -- it was just vile, watching this physically fit, vibrant, remarkably social man devolve into not just fear but terror, to waste to a terrored nothing. I'm not going that route. Un-unh. Not I. And. My brother died, last month, small-cell lung cancer, and I truly am grateful for the pain management he had, and for the care he received, and all of it, and he fought bravely, he did real well with radiation but this small cell lung cancer thing, it's nasty stuff, and it came on hard and fast at the end. Okay, so it was not but two weeks of absolutely remarkable suffering, just scared and sick and can't eat and horror show pain from his bones breaking as the cancer ate them up prior to that last two weeks. Still, was it me, that last two weeks, once I got the word from the docs that hey, it's over, we're done -- give me the helium, I'm outta here.

And I'm a person with fairly successfully treated manic depressive illness over here -- inaccurately called bipolar nowadays, another topic that is -- but it wasn't always fairly successfully treated, I had the type of depression that darkstar's mother apparently faced. Don't anyone dare say that people ought not to have the right to check out of this hotel when Jack Nicholson is busting through the damn door with that axe. Though thank god this is metafilter and people here are mostly awake. Anyways. I tried every drug I could shove into my head to get better. Nada. No dice. Suffer. I've had guns in my mouth, and never that I wanted to die, I knew how beautiful and all this thing is, it was just so unbearably painful. Go on, you cry like a kid with a dead puppy, you ache, and hurt, and can't make it stop -- go on, give that a whirl. Now do it for years. Then you have the right to make judgments about your own life. But not about mine. Nor anyone elses.

I got lucky. Late 2003, I put the right drug into my mouth, a drug that'd just recently been formulated, knew within days that this thing was different. A friend of mine describes it as "the background music in the movie of your life has changed, from heavy, scary, dirge to light sun-shiny day music.

Life is not so painful that I can't bear it any longer. I never did want to die and I damn sure don't want to now, regardless the limitations still on my life from this thing. It raised the floor of the depression.

But do you think that everyone is going to experience the kind of care -- outstanding, amazing, a whole 'nother story -- that I did? Do you think that they are going to have the support and the will and the luck to keep on going when they're wanting to quit? They're not, not all of them. And not everybody gets better, anyway; we want to think it's magic nowadays, there are so many good drugs and so much more understanding; still, not everyone gets better. And they need to have the right to leave if/when they want, if/when they decide to do so. You can say "Hey, shut up, you got better, so can Melvin over here." Yeah, well, maybe Melvin can. But maybe he can't And if/when it's time, when Melvin decides to blow on out of here, I like that he can find someone to give him the means and instructions for forty bucks.

And if I get sick like my brother, or if I get sick like my father, or anyone else gets sick like my father or my brother, I like that they or I can find someone to give me the means and the instructions for forty bucks.

I don't know, I guess it was a kneejerk reaction on my part. It just struck me as supremely arrogant that we can talk (and think it perfectly normal) about the most fundamental decision one can make as a human in such terms.
I'm perfectly aware about laws. I just don't think they are relevant here....

You guys are bringing up depression here. Someone's who is clinically depressed is not considered competent to make his own medical decisions. Just like someone in the middle of psychosis. But the question of competency does not extend to someone who's depressed because he's in unbearable pain from metastatic cancer that will kill him, and he cannot be helped. The former is mentally ill, the latter is not. And we have tests to differentiate the two.

And I think phycisian's job is to reduce suffering, not fight death. Clearly it's not the mainstream view.posted by c13 at 9:15 PM on April 30, 2011

I'm perfectly aware about laws. I just don't think they are relevant here....

If there were not laws prohibiting suicide, or prohibiting assisting suicide, then this entire debate would not be happening. The fact that the laws exist is the foundation of the problem. They could not possibly be more relevant.

And I think phycisian's job is to reduce suffering, not fight death. Clearly it's not the mainstream view.

I don't think many (if any) people here are disagreeing with you.

It seems to me that one problem is that the legal system is ill equipped to deal with situations that require nuance. The state doesn't want people to bump other people off, and then claim it was "assisted suicide" when it was, in fact, homicide for non-ethical motivations. Or they don't want mentally ill people to kill themselves when they could recover with treatment. So they ban it.

They could, as others have suggested, create a system that lets a person decide when they want to die, obtain the drugs they need to do so painless without administrative or legal difficulty or fear of prosecution, and die in (relative) comfort and with dignity (rather than a bullet to the temple, or the garage full of carbon monoxide...). But that's hard to manage, and philosophically and politically uncomfortable. So they impose a blanket ban, which seems, on the surface, nice and easy.

Another problem is the religious/conservative right, again seeking to impose their personal moral code on everyone, i.e., life is God's to give and take...suicide is a sin....etc.

c13: "... Someone's who is clinically depressed is not considered competent to make his own medical decisions. Just like someone in the middle of psychosis.But the question of competency does not extend to someone who's depressed because he's in unbearable pain from metastatic cancer that will kill him, and he cannot be helped. The former is mentally ill, the latter is not. And we have tests to differentiate the two."

Not everyone who is clinically depressed is so broken down that they can't think. We're sick, we're not stupid. I *knew* what I was facing, I *knew* what I was up against, I *knew* more than most shrinks I've ever sat in a room with about manic depression, the treatment of it, and the medications, and their side effects. I became a remarkably informed "consumer," I read every goddamn book that there was at that time, and no, I am not kidding. We're not all of us big dumbos, we're ill. Don't mentally ill people have the right to make informed decisions about their lives?posted by dancestoblue at 9:31 PM on April 30, 2011 [16 favorites]

If there were not laws prohibiting suicide, or prohibiting assisting suicide, then this entire debate would not be happening. The fact that the laws exist is the foundation of the problem. They could not possibly be more relevant.

Ok, let me try a different way: suppose we were talking about gay marriage. Discussing pros, cons, the fact that they are legal somewhere, the usual.. And someone came up and said that gosh darn, even though sodomy is against the law in a lot of places, it's probably more humane of us to allow them o marry rather than enforce the law.
Or like this: the foundation of the problem is the fact that we as a society think we can not only condem an individual to death, but we can also condem him to life. The fact that we have laws about it is the effect of this fundamental problem.

Dancestoblue, please don't be offended. I really don't know whether mentally ill people have the right to make decisions about their lives (I don't mean legally, as they obviously can't).
I had a six week rotation on a long term psych ward. There were 34 patients there. A lot of them * knew* a lot of things, and very few would admit they shouldn't be discharged....posted by c13 at 9:54 PM on April 30, 2011

For all the "I tried but failed at suicide but everything is good now" posts...

Is what I went through that last 12 years something someone should be forced to got through? There's not much future to look forward to, either. Just more of the same - but less of everything everyone has been promising me. A dozen plus fucking years. I tried, I didn't try, I didn't not try, I tried again and again and again and.posted by porpoise at 10:19 PM on April 30, 2011 [5 favorites]

For all the "I tried but failed at suicide but everything is good now" posts...

And I think it's worth keeping in mind that, of folks who tried, and failed, but nothing got better anyways-- their absence from this discussion doesn't mean it never happens to anybody, and there's an obvious reason why they're not here to share their experiences.posted by nathan v at 10:35 PM on April 30, 2011 [1 favorite]

As far as depression is concerned, many depressed people have extremely limited access to treatment. Insurance plans are slashing support for "mental" treatment and public supported options are drying up.

If you are poor and depressed, there may be no help available. Even if you could find an affordable doctor, can you afford the meds? If the meds don't work how do you try other ones when you've used up all your "allowable" doctor visits?

Trying to even get treatment can be an unsurmountable slog to a deeply depressed person.

Hey c13, no problems, not offended, annoyed if anything, and I don't know that I've gotten across, though I've said it as clear as I can.

First off, not all of us *know* things that aren't so, such as the people you ran across on your six week rotation on a locked ward. What you saw just maybe won't extrapolate out into the entire population. I don't know, maybe your time on that psych ward has tinted your vision and/or slanted you view to see every person who has a mental illness as being the same as those you saw there.

But a lot of us *know* what *is* so; you live the life for a while, and you learn all you can, and you're smart and determined to try to help yourself and help your shrink help you, you make it the most important thing in your life for a few years, hey, you get to know some things.

You saw things on a six week rotation. I've rotated through decades, literally decades of my life. I have a sense of it. And I have a sense of the illness which has determined so much of my life, for good or ill.

If I were to take offense at anything you've said, it would be that tone of condescension I'm reading (perhaps reading into -- do tell) in what you wrote. We do -- many of us -- we do in fact *know* one hell of a lot about this thing. Repeat: we are sick; we are not -- not all of us anyways -- we are not dumb, and we are not un-schooled.

And no, I don't go for that whole song and dance that manic depressive people are more creative than the average dope running the streets; just that we've sometimes got more juice, if/when we're running manic; if someone is talented, and running manic, they can then perhaps create twenty times as many canvases or operating systems as the person without that drive, whereas if they're not bright or talented but running manic they can obsess over sports trivia or royal wedding plates or make hollywood movies.

Anyways, I know you've been on the sharp end of it in this thread and you've been really graceful about it, nothing against you at all, you seem a fine citizen. Just that it's so easy to shove someone into a box, a category, and not look at the person themselves, their experience, and communicate with them, and not just what you've seen in your six week rotation in the psych ward, or for someone else, what they've seen in the latest tv movie or whatever.

I'll finish with this -- it doesn't matter how much you know, how smart you are or are not, how well connected you are or are not, how pretty your wife is or isn't, whatever other measure anyoine can dream up. If you have this thing -- and if this thing has you -- the pain just doesn't stop. And then it doesn't stop again. And then it doesn't stop some more. Read this: It doesn't stop. It claws at your guts. It goes on and on and on and on. Years. Decades, for me -- this whole thing kicked off in my early to mid teens and hasn't much rested since. I wanted to die. It hurts. Real, real bad. It's an illness. People have a right to determine their treatment, and the end of their treatment, too.

Sorry to go on and jump in here over and again; I do believe I've got some skin in the game in this issue.

After I saw my best friend die from the painful consequences of metastatic lung cancer, I'm convinced that even the best palliative care is not good enough. Four days, with a morphine pump delivering what seemed an insufficient dose in spite of the Hospice nurse efforts in increasing it, are too much.

When I have had enough, I will stop taking my meds: I hope I'll go fast then, of massive heart failure, just like my mother.posted by francesca too at 11:39 PM on April 30, 2011 [1 favorite]

You'd be surprised how likely... did you know that...

asphyxiation on non-CO2 gases is by far the easiest way to kill oneself

I actually was aware of this stuff — my point had nothing to do with criticism of the method, just the packaging of a kit. It seems like a needless risk taken by this woman, and frankly the device/kit looks pretty darn cheesy. My point was that this could simply be some instructions, costing perhaps $0 and available to all on the Internet. It would also be just about impossible for meddling politicians to do anything about. Helium is less dense than air, it should not be difficult at all to build your own device to effectively keep your head surrounded by it, especially given instructions telling you what to pick up at Home Depot.

My biggest problem was probably that I immediately began conjuring up a "Bill Mayes here with another fantastic product!" video...posted by floam at 1:20 AM on May 1, 2011 [2 favorites]

There seem to be a lot of risks involved with this.

First there are risks of bad decisions. People suffering severe depression probably shouldn't make irrevocable decisions. People who may be under pressure from friends or relatives probably shouldn't make irrevocable decisions. On the other hand, people who haven't discussed it with anyone probably shouldn't make irrevocable decisions, either.

Second there seems to be plenty of room for doubt about whether this will actually work properly. I assume the helium being fed in is meant to blow out the carbon dioxide, but it seems doubtful whether a mere plastic bag with a tube stuck in it can guarantee that will happen. Wouldn't you be better off using a proper mask of some kind (could you use a scuba mask)? If the bag doesn't work properly it could be an unpleasant way to go, or you might not die at all, or you might be left alive with brain damage?

Third there's the risk of straightforward murder. This provides a built-in cover story if you want to get rid of an unwanted relative.

For all these reasons, I think it's irresponsible. The clincher is that by making a half-baked job of it and encouraging people to go for it without adequate precautions or supervision this risks tragic outcomes and may in the end make it harder to get properly-managed euthanasia legalised.posted by Segundus at 1:31 AM on May 1, 2011 [3 favorites]

floam: I actually was aware of this stuff — my point had nothing to do with criticism of the method, just the packaging of a kit. It seems like a needless risk taken by this woman, and frankly the device/kit looks pretty darn cheesy.

The kit is nothing new. I don't know if it's still happening, but I'm pretty sure Exit (or some similar origination) sold pretty much the same kit a few years ago. I think their thought was to have something for people who might not trust themselves to assemble things correctly.posted by bjrn at 1:42 AM on May 1, 2011

Indeed, I share similar reservations about this device, Segundrus. In addition to the cheesy bag being a little questionable, another missed opportunity here is choosing helium as opposed to some other gasses. Helium makes the hood type thing work, but the problem with it being lighter than air is you breath it out easily. I think it'd be far more reliable to use a heavier-than-air gas, like sulphur hexaflouride, which will more readily in your lungs after breathing it in, and can be hard to expel fully. It should kill you just as well as helium would, displacing oxygen and not making you feel like you're not breathing the way the body reacts to CO2. Scuba gear works, or I imagine simply filling a bathtub with the stuff and getting in would work. And at least by selling a novel gas, people would be getting something for their money.posted by floam at 1:53 AM on May 1, 2011

Helium is usually the gas of choice because anyone can get it easily. You can get balloon sets with a tank of helium in a toy/party/etc store. I think it would be a fair bit more difficult to get your hands on a tank of sulphur hexaflouride. Also, if your hood is filled with helium breathing it out shouldn't be much of a problem because there's nothing but helium to breathe in anyway.posted by bjrn at 2:08 AM on May 1, 2011

both my parents died from a long painfull bout with deadly cancer, although my dad kept telling his grand children he was winning his battle with cancer, even the last days bed-ridden in a hospital, this lasted for weeks, getting worse daily and the hospital did not have any helium masks to help end the pain-full end that was advancing.posted by taxpayer at 5:25 AM on May 1, 2011

Setting a precendent for the commercialsation of suicide is a dangerous area. I do in fact support assisted suicide, but a kit to do it yourself commercially available? No matter what Sharlotte's experiences are in regards to watching someone suffer before death, this service she provides can be an encouragement for easy suicides by those who not in fact terminally ill.posted by ThenCameNow at 5:33 AM on May 1, 2011

Oh, by the way, I found the kit that Exit had, it's on the Peaceful Pill handbook website and is called the Betty Bag Kit, and it includes a instructional DVD too. The Peaceful Pill is a book that "[...] has been written for Seniors (& those who are seriously ill). In most western countries, the good death movement is expanding rapidly; those approaching their latter years want to know their end-of-life options."posted by bjrn at 5:53 AM on May 1, 2011 [3 favorites]

A couple of decades ago a woman I knew died suddenly of stomach cancer. Her son in law was a doctor. I asked him how it was that she was fine one day, merely had a stomach ache and then 11 days later was dead. Her son in law said she'd signed a living will. And I said, "So?" And he said that the doctors in the hospital looked into her stomach, saw that it had as many cancers as a bag of rice and then several days after the surgery administered morphine, enough to kill her. He said neither the patient nor her children wanted her to endure agony. After she'd said goodbye to her children the morphine was given.

I was shocked. I asked this doctor how that was legal and he spoke very dismissively, saying "It's done all the time by doctors and nurses."

Knowing this, when some years ago a guy I knew called in serious misery about his friend, who he said was dying an agonizing, prolonged death by cancer in the hospital, I told him what I'd learned and suggested he speak to the doctor in the hospital and say something like, "Please can you assist my friend to let go comfortably." Something like that. After saying that to the doctor, the next day his friend died.

Because of these two instances I assumed that unofficial assisted death happens all the time but the problem is that doctors do take the Hippocratic oath ("I will not give a lethal drug to anyone if I am asked, nor will I advise such a plan") and are obliged by that vow to save lives, not take them.

A hospice nurse told me that people are euthanized routinely when the patient is in unbearable agony, with morphine. Or the patients euthanize themselves with morphine.

So if a person wishes to be euthanized and does it on their own, it takes the legal, ethical, moral and social burden off the doctor or the nurse or the hospice person.

When it comes to depression there are many ways to commit suicide. Suicidal people are often not especially afraid of pain and kill themselves in atrocious ways, jumping off bridges, off buildings, self-immolation, hanging.

Why deprive the terminally ill or extremely elderly some dignity, choice and painlessness in their death for fear of worrying about offering somebody suicidal another variation?posted by nickyskye at 6:20 AM on May 1, 2011 [5 favorites]

How does one overcome the natural panic instinct when being asphyxiated? This doesn't seem to be the failsafe that everyone makes it out to be.posted by moammargaret at 7:02 AM on May 1, 2011

The panic comes from excess carbon dioxide, not too little oxygen. There are receptors in the lung that biochemically go nuts when the CO2 concentration in the lung goes high. (*) If you can devise a way to make sure the CO2 levels in the air you are breathing don't rise, you will just pass out.

There will be flailing and gasping and the like, but you will be unconscious.

(*) If you've ever accidentally breathed in right before taking a swig of a carbonated beverage and got that burning choking feeling, that is it.posted by gjc at 7:08 AM on May 1, 2011

I am generally opposed to suicide on the grounds that people often make bad choices when their state of mind is unclear, and perhaps things could improve and they could go on living to improve their lives and the lives of others.

On the other hand, forcing people to suffer from an incredibly painful and/or incurable disease (eg, pancreatic cancer, advanced lung cancer, etc.) seems barbaric, and why the Hell shouldn't someone who knows that death is inevitable and fast approaching be able to say "Fuck hospice and dying and undignified death" take charge and go out on their own terms?

The former Catholic in me keeps screaming 'Suicide is a mortal sin! You'll go to Hell!' but the rational part of me says that if there is a God (and I hope/think there is), then He/She is not the kind of God that would damn someone for not wanting to expire in excruciating pain, because that would really be fucked up.

In the case of terminal disease, I think it's far past the time for legislators to pull their heads out of their asses and set up a legal system for those who just want to opt out.

Because I doubt the lawmakers have ever been in the position where they might want to choose to pack it in.posted by bwg at 7:58 AM on May 1, 2011 [1 favorite]

I knew a nurse, years ago, who had assisted with two different suicides of terminal, pain-ridden patients. He described both of the deaths with extraordinary compassion; one was an AIDS patient who had wanted to die surrounded by friends, whose nightmare was to die by himself, and my friend made that possible.

He spent years wondering if he was going to be prosecuted for murder.

The informal, wink-wink, here's an unregulated morphine drip, we-know-nothing approach isn't enough. It's unreliable; you don't know if you're going to get a doctor brave enough to risk criminal and professional prosecution to assist you in dying. It's exposing those brave doctors to unthinkable risk.posted by MrVisible at 8:14 AM on May 1, 2011 [7 favorites]

Many elements of dancestoblue's story come straight out of my mother's story as well - the horrifying, crippling, manic depression for YEARS, the treatment after treatment, drug after drug, and the miracle drug that finally saved her and saved our family. I remember her time as an inpatient in the psych ward, I remember her stories about ECT (which thoroughly traumatized me as a kid, although I understand it much better now). She remembers very little of that time, thanks to the drugs and ECT. Incidentally, she remembers very little of my childhood.

I think that if there had been an option for her to gracefully exit the scene during the worst of her depression, she might have taken it. This would have prevented her from eventually getting the treatment that worked. It also would have saved her much pain and misery. It also would have prevented her from enjoying the rest of her life. There's such an inherent dilemma here, that I can't make up my mind on assisted suicide for people with depression/mental illness.

I mean, it's easy to say assisted suicide should be legal with few, low, barriers for people with terminal illnesses. That's not even a controversial position to take. But when it comes to people with mental illness, I can never separate myself from the knowledge that if it were possible, my mom would have taken that option when I was a child. I know that's not a rational argument - it can't be, because I'm basing it on MY feelings about MY mom. I tell my pro-death-penalty friend all the time "Of course a family who just lost a child to an awful crime would want the murderer killed. That's natural, normal, understandable. It's also why they don't get to be the judge and jury in their own case. Decisions would be based on their grief and not on the facts."

It's the same here, I can't say "yes, assisted suicide should be legal with few, low, barriers for people with mental illness," because that position could well have cost me my mother, who is so important to me and with whom I have shared many many happy times since the miracle drug brought her out of the darkness. But I know that saying the opposite, that assisted suicide should not be available for people like my mom, is selfish and presumes that people with mental illness can't/should not be trusted to make their own decisions. Maybe no amount of happy memories could ever balance the scale against the misery she endured. I can't say, not from her perspective, and since the ECT she's not really self-reflective enough for me to ask.

I can uncomfortably say that my experience has made me incapable of holding a position on the topic. That's tricky too - if you can't go solely by the affected person, because their mental illness COULD make their decisions suspect, and you can't go by their families, because we have a strong vested interest in keeping our loved ones around, and people who've never dealt with mental illness may not have the depth of understanding to make the most caring decision for everyone involved... whose arguments get priority?

To me, this is exactly where our philosophers and ethicists come in. I would trust a philosopher to be able to think more clearly about this than I could, and to be able to balance the needs and wishes of the concerned people more fairly that I as well. Unfortunately, this is instead where the politicians step in, and every decision then gets made based on the political capital it will gain or lose.posted by arcticwoman at 8:45 AM on May 1, 2011 [3 favorites]

Articwoman: You may be interested in reading "the philosophers' brief," a really compelling amicus brief by a number of prominent philosophers filed with the Supreme Court in support of a right to assisted suicide. The court didn't buy it, but, it's very persuasive.posted by dixiecupdrinking at 9:00 AM on May 1, 2011 [1 favorite]

Just a thought but on the mental illness front, maybe suicide could be considered a valid choice after all of the best treatments have been tried and found to be a failure. But then we'd have to offer all of the best treatments to every mentally ill person, and that can be expensive and society doesn't really give a shit about them. I mean, about us.

I am bipolar and was saved by a miracle combination of pills myself (it took years and years to find something that worked, and my life was a wreck until then). I would never have killed myself though, no matter how much I wanted to. My family's pain at my death would outweigh my right to any sort of relief from my suffering, as crushing as it was. And now I have a daughter so even if the pills stop working it's not an option, but I think it should be an option for those who want it.

But like I said, I think it makes some sense to restrict it to people who have had a fighting chance at getting relief from trying a bunch of different quality treatments. The state of mental health care for the poor is abysmal though. At one point I was told it would take six months for an intake appointment. Just ludicrously cruel, and no wonder a lot of people don't make it.posted by marble at 9:07 AM on May 1, 2011 [1 favorite]

Mental illness ranks pretty high as far as disabling conditions go. Schizophrenia is number three, I believe, after quadriplegia and dementia. So logically, since I advocate individual autonomy in cases where someone wants to check out due to some physical issue, I should also advocate the same for mentally ill. It is just that some of the mentally ill have really big problems with reality testing and the whole competency thing gets a lot more complicated. Who exactly wants to kill himself during a psychotic episode?
On the other hand, is it ethical, after all efforts and meds have failed, to keep someone locked up and drugged out of his mind?
Our aversion to suicide comes from our Judeo-Christian roots, I think. The big dude in the sky is pissed at us 'cause Eve ate that apple (or was it mushroom?), and wants us all to suffer. Therefore trying to avoid the suffering is against god's will. We got better at separating myth and how we operate the government, but still have a very long way to go in other areas.posted by c13 at 9:25 AM on May 1, 2011 [1 favorite]

My mother has had MS since 1964; she currently lives in a nursing home for people with severe disabilities, most of whom are quadriplegic, in electric wheelchairs or bedridden, and all of whom require 24 hour care. Some are only paraplegics and mentally fine, but have major communication issues (they can't speak, and thus can't function without help); many, like Mom, are mentally fine but physically trapped in a non-functioning body; many are demented or mentally retarded; some are bedridden, unable to speak or swallow, and dependent on feeding tubes.

Mom, and many of those she lives with, are opposed to assisted suicide -- mostly because they suspect that if it were legalized, those who care for them would be open to the idea that their lives aren't worth living, and that surely they'd want to end them. Pressure would be brought to bear, personally and politically; how can you justify living like this? Don't you know that your care is expensive? Surely you'd be better off dead? When the family savings are being depleted because of your care, or when your child is exhausting themselves to look after you, simply choosing to live can be seen as an act of monumental selfishness.

As it is, most of the unpleasant people the nurses truly dislike, or those who have family or friends who live at a distance or who rarely visit will spend days in a dirty diaper, or with the straw for the water bottle a half and inch out of reach.posted by jrochest at 10:19 AM on May 1, 2011 [2 favorites]

Helium used to be the method of choice prescribed by the Voluntary Human Extinction Movement before they took down their 'instructions' page...they had a whole list of reasons for it being the best, but the ones that really struck me as being particularly humane were:
a) painless...no CO2 response
and
b) tidy...that whole bit about not leaving your loved ones with the horrible job of cleaning your brains of the wall, or a bathroom full of blood...yeah, that's nice. (and for those who've had to take on that task...yikes...ugh, i cant imagine....)

and oh god, doctor Kevorkian...yikes...while i totally believe in what he stands for, and that assisted suicide should be made available to those who need it, i equally believe that he enjoys the task...don't believe me? google up his paintings...posted by sexyrobot at 11:07 AM on May 1, 2011

Dr. Kevorkian's paintings are more concentrated on human suffering and the fate that awaits all of hs.
Does he enjoy it? Why speculate, it was what he referred to as his passion to help those who were being ignored by the medical community. Dr. Kevorkian also turned down many people due to a variety of reasons (depressed, not clinically ill/terminally ill). Hell, he even ran for congress after getting out of jail on the platform of assistant suicide.posted by handbanana at 11:29 AM on May 1, 2011 [4 favorites]

Mom, and many of those she lives with, are opposed to assisted suicide -- mostly because they suspect that if it were legalized, those who care for them would be open to the idea that their lives aren't worth living, and that surely they'd want to end them. Pressure would be brought to bear, personally and politically; how can you justify living like this? Don't you know that your care is expensive? Surely you'd be better off dead? When the family savings are being depleted because of your care, or when your child is exhausting themselves to look after you, simply choosing to live can be seen as an act of monumental selfishness.

Likewise, many people in similar situations support assisted suicide because they do believe that their lives aren't worth living, and do want to end them, but are kept from doing so by personal and political pressure. How can you justify suicide? Don't you know that your life is sacred? Don't you know it's illegal? When family members can't face the decision, or when your child is exhausting themselves to look after you, simply choosing to die can be seen as an act of monumental selfishness...

Frankly, I can see both sides of the issue. That's why personal choice is the only honest solution -- the only way to keep people from being forced to end their lives in ways they otherwise would not.posted by vorfeed at 1:36 PM on May 1, 2011 [1 favorite]

I understand the arguments from family members who suspect or are certain that their loved ones would take chosen suicide if it were legal, assured of the desired result, and not adding trauma along the lines of cleaning up blood and brains to their loved ones' burden. All the same, that is ultimately a selfish argument, "You/she/he can't die because I need/want/love you."

I may be on the fringe with this one, but I believe strongly in autonomy, and central to my concept of autonomy is ownership of self, body, and mind. If I want to put a bunch of extra holes in my body (piercing), art on my body, implants in my body, or remove what I see as "extra" bits (most likely breasts, testicles and/or penis, ovaries and/or uterus, uterine growths including tumors and fetuses, and the occasional digit or limb), dye my skin funny colors like bright orange (see Boehner, John), indulge in the use of mood-altering substances, or stop my respiration and heartbeat, then as long as I'm an adult and not directly imposing the results of those choices on others (as in suicide by fire or driving under the influence), I think I ought to legally be able to do those things. I think everyone ought to have those options, as autonomous adults.

And yes, it would be tragic if a new drug came out that would have improved quality of life for a suffering person to the point where their choice would be different had they only waited, but I think the bigger tragedy overall is in the pain and suffering inflicted as a result of not allowing personal autonomy.

For what it's worth, I say this as someone who has lost people I cared about both to suicide and to horrible terminal illnesses, the loss of whom I still grieve.posted by notashroom at 3:55 PM on May 1, 2011 [1 favorite]

I hate to be pro-death. Why not build a world in which the old are cherished, loved, listened to? even if they're not wealthy. Instead, old people are stored in nursing homes, with adequate care but no joy. We have, or should have, the ability to manage pain, and many indignities are avoidable. As American baby boomers age, I'm sure this will end up being embraced, and many people will die with dignity, and loneliness.posted by theora55 at 4:03 PM on May 1, 2011 [2 favorites]

All the same, that is ultimately a selfish argument, "You/she/he can't die because I need/want/love you."

The problem is that the voices of the healthy and non-disabled dominate debates on these issues, and their arguments can all be viewed as selfish in some ways, from "you can't die because I need you" to "I couldn't stand to see him/her suffer like that." The opinions of people without illnesses or disabilities about whether or not they would ever want to "live like that" shouldn't be the only ones that we hear.posted by Ralston McTodd at 5:13 PM on May 1, 2011 [1 favorite]

I hate to be pro-death. Why not build a world in which the old are cherished, loved, listened to? even if they're not wealthy. Instead, old people are stored in nursing homes, with adequate care but no joy. We have, or should have, the ability to manage pain, and many indignities are avoidable. As American baby boomers age, I'm sure this will end up being embraced, and many people will die with dignity, and loneliness.

I totally agree with you-- that'd be a better world. And I want people to work toward it. I hope that I work toward it. (I'll try sometimes, and get fed up sometimes, and hopeless and selfish sometimes, and then try again later, I imagine.)

At the same time, I think it's important to be honest about why the world is not that way (to the extent that it's not: efforts to cherish people in pain exist, yes, even in those frequently maligned nursing homes). Because there is a shortage of labor (which is what "shortage of money" means). And the aging of US baby boomers is going to exacerbate that labor shortage, not relieve it.

I think we have to accept some responsibility, each of us, for the time we're spending on pursuits other than bringing joy to the pained. There's no ideal balance of taking care of other people and taking care of ourselves, so of course, we can each be forgiven to the extent that we take care of ourselves; but we can't deny that responsibility, even as we understandably shirk it.posted by nathan v at 5:37 PM on May 1, 2011 [2 favorites]

Why not build a world in which the old are cherished, loved, listened to? even if they're not wealthy.

That would be lovely and is an admirable goal. It would do nothing to address the problems of somebody facing death from (for example) ALS. Cherish them, love them, and listen to them all you want — they're still facing the 100% (as far as we know) certainty that they are going to die early in a particularly difficult way.

If somebody who's been diagnosed with ALS sees a short future of nothing but increasing levels of these symptoms and decides they'd rather go out at a time they choose when they still have some bodily control... I don't feel qualified to tell them that's the wrong thing to do.posted by Lexica at 6:07 PM on May 1, 2011 [2 favorites]

Why not build a world in which the old are cherished, loved, listened to? even if they're not wealthy.

(I love old folks. When I had more free time on my hands, I used to visit over at the veteran's home near my town. It's absolutely heart-shredding to see how joyful many of them could be, just to have someone sit next to them and listen to their stories, rants, and reminiscences. And boy, did they ever have some fascinating stories to tell. Especially the ones on the Alzheimer's ward.)posted by Gator at 7:15 PM on May 1, 2011 [1 favorite]

Good for her.

My grandmother used Oregon's death with dignity act.

She had terminal cancer that was discovered very late, and had lived a long, beautiful, full life - her five children and all of us grandkids spent quality time with her after she was sick - and when things really started to go downhill and she had just months to live, she decided that she wanted to have control over her death, just as she had during life - that she wanted to say goodbye on her terms, settle her affairs, choose what her last day would be like.

And so with her daughters by her side, she laid down in her bedroom and took the pill her doctor had prescribed, she went to sleep, and passed away, peacefully.

Sometimes when people think about this they imagine a horribly miserable person who is trying to escape life. But she was happy, very much alive, loved and safe, and she chose to face her death with the same courage she faced her life, and I think it was beautiful.posted by jardinier at 8:18 AM on May 3, 2011 [4 favorites]

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